Rajiv Sinha R, et al. -- Researchers performed the trial to determine whether use of antibiotics reduces voiding cystourethrogram (VCUG)-associated urinary tract infection (UTI). They reported that use of antibiotics significantly reduce post-VCUG-acquired UTIs especially in those with abnormal ultrasound scans.

Methods:

• This was an open-labelled randomized controlled trial preformed at a tertiary paediatric nephrology centre.
• Children were randomized into group A (antibiotic, n=72) or group B (no antibiotic, n=48) in 3:2 ratio.
• Group A received oral antibiotic (cephalexin if <6 months or co-trimoxazole if >6 months old) a day prior to VCUG and continued for 1 day post VCUG.

Results:

• The median age was 8 months (IQR 13 months) with 68% male.
• Indication for undertaking VCUG was history of UTI (first UTI in infancy=43, recurrent UTI=49) and congenital anomaly of kidney and urinary tract without any UTI (n=28).
• Post-VCUG UTI was significantly higher among group B in comparison to group A.
• Multivariate binary logistic regression analysis found an abnormal pre-VCUG ultrasound scan to be a significant independent risk factor for post-VCUG UTI.
• The number needed to treat with antibiotic to prevent one post-VCUG UTI was 6.5, which reduced to 4 if only the group with abnormal pre-VCUG ultrasound scan was included.